A good birth experience is more than the baby being delivered alive

A Mumsnet survey shows the psychological impact of a difficult labour affects the child's future wellbeing as well as the mother's

Joanna Moorhead

theguardian.com, Wednesday 16 October 2013 12.44 BST

'The charity Birthrights is calling for a reappraisal of how we judge a successful birth: 

no longer should it be merely about physical health, but psychological health as well.

' Photograph: Pascal Deloche/Godong/Corbis

Listen to any group of new parents talking about their birth experience, and here's a phrase you'll almost certainly hear. "At least," someone will say, "the baby was all right. That's all that really matters." That comment will come after one of the group has poured out a story that fell very far short of ideal – a story in which she felt she was ignored, not listened to, disempowered, neglected. A birth that typically started well, but turned into a scary (sometimes terrifying) rollercoaster, from which the new family was left so shaken that they were genuinely grateful that they were even still alive.

But the fact that the mother and baby are still alive isn't the only thing that matters. Certainly not in 2013, when birth is safer than it's ever been: today, the risk that either you or your baby won't make it is minute. So how come we're still setting such a low bar for our ideas of whether childbirth was successful? And what damage is that doing to our children?

These questions are at the heart of a campaign launching today that calls for a rethink on what matters most in childbirth in the western world in the 21st century. Childbirth charity Birthrights is calling for a reappraisal of how we judge a successful birth: no longer should it be merely about physical health, but about psychological health as well. According to new research carried out by Mumsnet for Birthrights, fewer than half of all women in the UK get the birth they want.

The new figures, based on a survey of 1,100 Mumsnet users who have had babies in the past three years, found only 68% of pregnant women were given a choice about where to give birth, 31% did not feel in control of their birth experience; 23% said they weren't given a choice about where they wanted to be during labour, and 18% didn't think health professionals had listened to them. A shocking 24% of women who had had instrumental births said they had not consented to the procedure.

And does it matter? Yes it does. In fact, the body of evidence about how much it matters is mushrooming, so that it seems almost absurd to anyone who knows anything about children's development that we still think that a baby's physical health at the birth is all that matters. The Mumsnet survey gives a clue to why: most of the mothers questioned said their baby's birth affected how they felt about themselves, and 41% felt that impact was negative (rising to 73% in women who had had instrumental deliveries). Almost half the women questioned thought the birth experience had affected their relationship with their baby, and for 22% the impact was negative; again, for women who had an instrumental delivery that proportion rose dramatically, to 59%.

The survey didn't give figures on fathers, but it's clear from other research that the way a birth pans out affects a father's early bonding with his child, as well as his future relationship with his partner. And all of that is vital in providing the newborn with an environment that's as secure as possible, because security is what every child needs in early life.

Ask any child development specialist, and they'll tell you the same thing: the best predictor of a child's future wellbeing, future educational attainment, future mental health and future happiness is the quality of the bond formed between that child and his or her primary caregivers in the hours, days, months and years after birth. When a woman begins her life as a mother feeling low in confidence, unsure about how she feels about her child and unhappy in herself, she won't be as able to give herself to the bonding process as she will if she embarks on motherhood feeling in control, empowered and validated by the experience. Give a new mother confidence, and you give her the best possible start in the hardest job in the world – and that's the best possible start you can give her baby, too. Give her a good birth experience, and the road ahead is at least on a level, and maybe even downhill. Give her a traumatic birth, and you give her a hill to climb – and, of course, she has a baby to carry as well. Birth isn't just about two people still breathing: we're doing the next generation a huge injustice by assuming it is.

Fuente: http://www.theguardian.com/commentisfree/2013/oct/16/good-birth-experience-baby-alive-mumsnet